Using Vital Records for Epidemic and Disease Surveillance

For more than a hundred years, the United States has operated a decentralized vital statistics system (National Vital Statistics System- NVSS) as an essential reporting component of public health. The reporting of mortality through the NVSS is the primary source of data used to track longevity and leading causes of death at the national state and local level. Although of considerable historical interest, this information has been collected and distributed in such a manner as to make it quite useless for monitoring current public health outcomes. There are developments in several states that provide hope that this situation can be significantly improved. States have shown that the development of Electronic Death Registration Systems (EDRs) throughout the United States with associated web-based tutorials is both feasible and affordable and can significantly improve data timeliness such that its mortality reporting could in the future be considered an essential component in public health surveillance. This presentation will discuss the extent of implementation of EDR's, how they work, challenges they face and changes in how NCHS will process these data to make them available. The reporting of mortality associated with H1N1 will be used as an example of what the future could hold for a rejuvenated NVSS which would provide rapid information for epidemic and bioterrorism surveillance as well as an early warning system for the identification of emerging diseases.